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Wilderness: Ciguatera Toxin (cont.)

Ciguatera Fish Poisoning (Toxin) Treatment

There is no specific antitoxin available for ciguatera toxin.

  • Some investigators have suggested vomiting should be induced if the victim is awake and alert and has eaten ciguatera toxin-containing fish within the last 3 to 4 hours. Ipecac, a substance that causes vomiting, was suggested as the medication to use, but many investigators now think ipecac causes too much dehydration. Currently some physicians recommend gastrointestinal decontamination with activated charcoal. Activated charcoal may absorb the toxin if done 3 to 4 hours after ingestion.
  • Maintain hydration. Intravenous fluids may be necessary for uncontrollable nausea and vomiting.
  • No specific antidote is available.
  • Osmotic diuretics have been used to decrease symptoms (for example, mannitol [Osmitrol]).
  • Amitriptyline (Elavil, Endep) and gabapentin (Neurontin, Gralise, Horizant) may help reduce neural pain symptoms
  • Diphenhydramine (Benadryl) and hydroxyzine (Atarax, Vistaril) may help relieve itching.
  • NSAID's and acetaminophen (Tylenol and others) may reduce pain
  • Avoid alcohol, fish, nuts, and nut oils after exposure to ciguatera toxin because they may trigger recurrent symptoms.

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Read What Your Physician is Reading on Medscape

Toxicity, Ciguatera »

Ciguatera poisoning is the most common nonbacterial, fish-borne poisoning in the United States.

Read More on Medscape Reference »


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